title: To what extent does employer-paid health insurance reduce the use of public hospitals?
abstract: OBJECTIVE
  This study examines the extent to which employer-paid health insurance has led to substitution of public with private hospital use in Denmark.
  
  
  METHODS
  Individual-person-level data for the entire Danish privately employed, full-time working population is used in an observational design. The effect of having employer-paid health insurance on the utilisation of public hospitals is estimated using propensity score matching in order to control for risk selection, based on a number of individual- and company-level characteristics. The outcome is defined as the total consumption of health care services provided by public hospitals.
  
  
  RESULTS
  The effect of employer-paid health insurance is estimated to correspond to a significant 10% reduction in the total use of public hospitals. The effect appears to be robust to alternative methodological specifications and is supported from the analysis of alternative outcome measures.
  
  
  CONCLUSIONS
  The rise in the number of individuals with employer-paid health insurance seems to have alleviated the pressure on public hospitals in Denmark. Future studies should confirm the magnitude of this effect, preferably based on empirical data with repeated measurements of insurance status.
authors.affiliation: Centre for Health Services Research (CAST), University of Southern Denmark, J.B. Winsløws Vej 9B, 5000 Odense, Denmark; Centre of Health Economics Research (COHERE), Department of Business and Economics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark. Electronic address: ris@cast.sdu.dk.
authors.forename: Rikke
authors.initials: R
authors.lastname: Søgaard
authors.forename: Morten Saaby
authors.initials: MS
authors.lastname: Pedersen
authors.forename: Mickael
authors.initials: M
authors.lastname: Bech
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003657:Decision Making; D003718:Denmark; D005260:Female; D006264:Health Benefit Plans, Employee; D006779:Hospitals, Public / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D012042:Registries; D018570:Risk Assessment; D013660:Taxes; D019472:Universal Health Insurance
keywords: Danish health care system; National Health Service; Policy evaluation; Private health insurance; Propensity score matching